NSG 444A Final Exam V3 | NSG 444A
Transition to Practice | Actual Q&A with
Rationale (NSG444A Final Exam) | Grand
Canyon University
1. A charge nurse is preparing to delegate tasks to an unlicensed assistive personnel (UAP).
Which tasks are appropriate for the RN to delegate to the UAP? Select all that apply.
A. Assisting a stable patient with ambulation for the first time post-surgery.
B. Performing a sterile dressing change on a central line.
C. Collecting a clean-catch urine specimen.
D. Documenting the intake and output for a patient on telemetry.
E. Re-applying pneumatic compression sleeves.
F. Evaluating the effectiveness of pain medication administered 30 minutes ago.
Correct Answer: C, D, E
Explanation: The RN must delegate tasks that are routine and do not require clinical
judgment or assessment. Collecting a urine specimen, documenting I&O, and re-applying
compression sleeves are considered standard tasks for a UAP. Assessing a patient for the
first time post-op or performing sterile procedures are responsibilities that remain with
the licensed nurse.
,2. According to Benner’s stages of clinical competence, a nurse who has been working on a
medical-surgical unit for 3 years and begins to see the ‘big picture’ of patient care is in which
stage?
A. Novice
B. Advanced Beginner
C. Competent
D. Proficient
Correct Answer: D
Explanation: The proficient nurse perceives situations as wholes rather than in terms of
chopped-up parts or aspects. This stage occurs when the nurse has enough experience to
recognize when the normal clinical picture is not present. It follows the competent stage
and precedes the expert stage in Benner’s model.
3. A nurse is caring for a patient who refuses a life-saving blood transfusion due to religious
beliefs. The nurse supports the patient’s right to refuse treatment. Which ethical principle is
the nurse demonstrating?
A. Beneficence
B. Nonmaleficence
C. Justice
D. Autonomy
,Correct Answer: D
Explanation: Autonomy refers to the right of the patient to make their own decisions
regarding their healthcare. Even if the nurse disagrees with the decision, they must respect
the patient’s self-determination. This principle is a cornerstone of professional nursing
practice and legal patient rights.
4. A nurse manager is using Lewin’s Change Theory to implement a new electronic health
record system. Which action represents the ‘Unfreezing’ stage?
A. Identifying the need for change and creating awareness of the current system’s flaws.
B. Providing hands-on training for all staff members.
C. Setting the new system as the permanent standard of care.
D. Monitoring the long-term outcomes of the system implementation.
Correct Answer: A
Explanation: Unfreezing involves creating the motivation for change by helping
individuals realize that the current status quo is no longer effective. During this phase, the
manager highlights the necessity of the transition to ensure staff buy-in. Once the need is
recognized, the moving or changing phase can begin.
5. The nurse is prioritizing care for four patients. Which patient should the nurse assess first?
A. A patient with a history of COPD complaining of shortness of breath with exertion.
B. A patient with a suspected pulmonary embolism who is suddenly restless and confused.
, C. A patient who is 1-day postoperative and reporting a pain level of 6/10.
D. A patient with diabetes whose blood glucose level was 180 mg/dL before lunch.
Correct Answer: B
Explanation: Sudden restlessness and confusion are early signs of hypoxia, indicating a
life-threatening airway or breathing issue. According to the ABC (Airway, Breathing,
Circulation) priority framework, this patient requires immediate intervention. The other
patients are stable or experiencing expected symptoms for their conditions.
6. A nurse is involved in a Root Cause Analysis (RCA) following a sentinel event. What is the
primary purpose of an RCA?
A. To identify and punish the individuals responsible for the error.
B. To satisfy legal requirements for hospital accreditation.
C. To document the event for the hospital’s legal defense team.
D. To identify system-wide failures and prevent future occurrences.
Correct Answer: D
Explanation: Root Cause Analysis is a process used to investigate the underlying causes of
a serious error or sentinel event. The focus is on system improvements rather than blaming
individual staff members. By identifying where processes failed, the facility can implement
changes to enhance patient safety.
Transition to Practice | Actual Q&A with
Rationale (NSG444A Final Exam) | Grand
Canyon University
1. A charge nurse is preparing to delegate tasks to an unlicensed assistive personnel (UAP).
Which tasks are appropriate for the RN to delegate to the UAP? Select all that apply.
A. Assisting a stable patient with ambulation for the first time post-surgery.
B. Performing a sterile dressing change on a central line.
C. Collecting a clean-catch urine specimen.
D. Documenting the intake and output for a patient on telemetry.
E. Re-applying pneumatic compression sleeves.
F. Evaluating the effectiveness of pain medication administered 30 minutes ago.
Correct Answer: C, D, E
Explanation: The RN must delegate tasks that are routine and do not require clinical
judgment or assessment. Collecting a urine specimen, documenting I&O, and re-applying
compression sleeves are considered standard tasks for a UAP. Assessing a patient for the
first time post-op or performing sterile procedures are responsibilities that remain with
the licensed nurse.
,2. According to Benner’s stages of clinical competence, a nurse who has been working on a
medical-surgical unit for 3 years and begins to see the ‘big picture’ of patient care is in which
stage?
A. Novice
B. Advanced Beginner
C. Competent
D. Proficient
Correct Answer: D
Explanation: The proficient nurse perceives situations as wholes rather than in terms of
chopped-up parts or aspects. This stage occurs when the nurse has enough experience to
recognize when the normal clinical picture is not present. It follows the competent stage
and precedes the expert stage in Benner’s model.
3. A nurse is caring for a patient who refuses a life-saving blood transfusion due to religious
beliefs. The nurse supports the patient’s right to refuse treatment. Which ethical principle is
the nurse demonstrating?
A. Beneficence
B. Nonmaleficence
C. Justice
D. Autonomy
,Correct Answer: D
Explanation: Autonomy refers to the right of the patient to make their own decisions
regarding their healthcare. Even if the nurse disagrees with the decision, they must respect
the patient’s self-determination. This principle is a cornerstone of professional nursing
practice and legal patient rights.
4. A nurse manager is using Lewin’s Change Theory to implement a new electronic health
record system. Which action represents the ‘Unfreezing’ stage?
A. Identifying the need for change and creating awareness of the current system’s flaws.
B. Providing hands-on training for all staff members.
C. Setting the new system as the permanent standard of care.
D. Monitoring the long-term outcomes of the system implementation.
Correct Answer: A
Explanation: Unfreezing involves creating the motivation for change by helping
individuals realize that the current status quo is no longer effective. During this phase, the
manager highlights the necessity of the transition to ensure staff buy-in. Once the need is
recognized, the moving or changing phase can begin.
5. The nurse is prioritizing care for four patients. Which patient should the nurse assess first?
A. A patient with a history of COPD complaining of shortness of breath with exertion.
B. A patient with a suspected pulmonary embolism who is suddenly restless and confused.
, C. A patient who is 1-day postoperative and reporting a pain level of 6/10.
D. A patient with diabetes whose blood glucose level was 180 mg/dL before lunch.
Correct Answer: B
Explanation: Sudden restlessness and confusion are early signs of hypoxia, indicating a
life-threatening airway or breathing issue. According to the ABC (Airway, Breathing,
Circulation) priority framework, this patient requires immediate intervention. The other
patients are stable or experiencing expected symptoms for their conditions.
6. A nurse is involved in a Root Cause Analysis (RCA) following a sentinel event. What is the
primary purpose of an RCA?
A. To identify and punish the individuals responsible for the error.
B. To satisfy legal requirements for hospital accreditation.
C. To document the event for the hospital’s legal defense team.
D. To identify system-wide failures and prevent future occurrences.
Correct Answer: D
Explanation: Root Cause Analysis is a process used to investigate the underlying causes of
a serious error or sentinel event. The focus is on system improvements rather than blaming
individual staff members. By identifying where processes failed, the facility can implement
changes to enhance patient safety.
